By giving everyone paper rights to health care, Americans may end up doing little better, at much greater cost, and feeling worse about it. The key to providing greater equity may be to find a way of defining the minimum that all should have. Most countries somehow define these limits for publicly provided services from education to cash assistance. But for health care benefits there are no simple limiting criteria--especially when professionals have the exceptional luxury of using whatever resources they choose. A realistic floor requires toughly maintained ceilings.